3210 East Layton Ave Cudahy, WI 53110

You need to have javascript enabled beforeyou can fill out our online credit application..

Please enable javascripting in your web browser to continue.

Secure Credit Application

Your application will be submitted via our secure server connection.

Fields in blue are required

Credit Information

Individual Credit - unmarried applicant.

Individual Credit - married applicant.

Joint Credit - with your spouse.

Joint Credit - with another applicant or cosigner who is not your spouse.

NOTE: If applying for Joint Credit with someone other than your spouse, each of you mustcomplete a separate application.

Loan Information

Vehicle you are interested in:

Purpose of loan:

Loan amount requested:

Desired # of monthly payments:

Desired monthly payment:

Amount Down:

Personal Information

Full Name

Marital Status:

Social Security #:

-
-

Drivers License & Exp Date

-
/
/

Date of Birth:

/
/

Email Address:

Cell Phone: eg: 234-555-1212

Street 1:

Street 2:

City / State / Zip:

Date you started living at this address:

/
/

Have you lived at the above address for more than 5 years?
yes
no

Previous Address

Street 1:

Street 2:

City / State / Zip:

Date you started living at this address:

/
/

Financial Information

Current Bank:

Bank's Address:

Check all that apply:

checking
savings
loan
credit card
other

Have you declared bankruptcy within the last 7 years?
yes
no

Are you planning to file bankruptcy anytime in the future?
yes
no

Number of Dependants:

Current Employer

Employer Name:

Job Title:

Phone Number: eg: 234-555-1212

Date you began working there:

/
/

How long have you been working there:

Gross monthly income before taxes:

Previous Employer(if less that 2 years at current job)

Previous Employer:

Previous Job Title:

Phone Number: eg: 234-555-1212

Date you began working there:

/
/

Additional Income

Additional Monthly Income:

Additional Monthly Income:

NOTE: Alimony, child support or separate maintenance income need not be revealed if you donot wish to have it considered as a basis for repaying this obligation.

Spouse's Personal Information

Spouse's Full Name

Spouse's Social Security #:

-
-

Spouse's Drivers License & Exp Date

-
/
/

Spouse's Date of Birth:

/
/

Spouse's Email Address:

Spouse's Home Phone: eg: 234-555-1212

Spouse's Cell Phone: eg: 234-555-1212

Street 1:

Street 2:

City / State / Zip:

Date your spouse started living at this address:

/
/

Has your spouse lived at the above address for more than 5 years?
yes
no

Spouse's Previous Address

Street 1:

Street 2:

City / State / Zip:

Date your spouse started living at this address:

/
/

Spouse's Financial Information

Spouse's Current Bank:

Spouse's Bank Address:

Check all that apply:

checking
savings
loan
credit card
other

Has your spouse declared bankruptcy within the last 7 years?
yes
no

Is your spouse planning to file bankruptcy anytime in the future?
yes
no

Number of Dependants:

Spouse's Current Employer

Spouse's Employer Name:

Spouse's Job Title:

Phone Number: eg: 234-555-1212

Date your spouse began working there:

/
/

Gross monthly income before taxes:

Spouse's Previous Employer(if less that 2 years at current job)

Spouse's Previous Employer:

Spouse's Previous Job Title:

Phone Number: eg: 234-555-1212

Date your spouse began working there:

/
/

Spouse's Additional Income

Spouse's Additional Monthly Income:

Spouse's Additional Monthly Income:

NOTE: Alimony, child support or separate maintenance income need not be revealed if you donot wish to have it considered as a basis for repaying this obligation.

Financial Debts / Obligations

Type of Debt

Holder

Balance

Monthly Payment

Personal References

Relationship

Name

Address

Phone

Check this box to authorize us to share your nonpublic personal information with affiliated and/or nonaffiliated third parties.
I understand that in checking this that you may be better able to serve me and that I may receive offers for other products and services that may be of value to me.
Please read our privacy policy for more information regarding your rights and how we use the personal information you submit to us.

Please type your full name here:
(This will act as your digital signature. Your application cannot be accepted unless this is signed.)

FAIR CREDIT REPORTING ACT DISCLOSURE:

This application for credit may be submitted by the Dealer to various financial institutions.
Before this application is submitted, the Dealer will disclose to you the name and address of the institution(s) who will receive copies of this application.

By clicking on the 'submit' button below I certify that the above entered information to be true and correct and I hereby authorize you to use this information to perform a credit rating check of my personal credit.
I also certify that I am over the age of 18 and am a current U.S. citizen or permanent resident.
In addition, I understand that submitting the above information does not represent an obligation by any party to provide credit nor does it obligate me to accept any credit offered.